Dissociation: Understanding the Impact of Relational Trauma

Dissociation: Understanding the Impact of Relational Trauma

If you’ve ever driven to a familiar place and arrived not remembering how you got there, you could be said to ‘dissociate’ from time to time – that is, to disconnect your conscious mind from your bodily experience.

Dissociation is an adaptive, automatic and universal mechanism of the mind that shapes our conscious sense of self. Contemporary thinkers see each of us as a collection of ‘self-states’ – aspects of self, each with its own set of feelings, memories, values, and thinking capacity. At a level of healthy functioning, we move fluidly between self-states to adapt to our environment. However in some circumstances, dissociation will lock out particular self-states or prevent them from developing.

Dissociation and trauma

Imagine a situation in which your survival is at stake, for example a car crash or violent assault. In the face of a potentially annihilating event like these, we may be terrified yet powerless. This is trauma (even if the anticipated event does not ultimately happen). Unable to fight or to flee, our only remaining possible response is to freeze, effectively to dissociate. We see this in animals, when they ‘play dead’ in the face of predator threat. Bodily systems drastically slow down, and the overwhelmed conscious mind (or left brain) goes offline.

Survival through dissociation comes at a price. As the conscious mind is not there to process emotion, record, remember or make sense of what is happening, the traumatic experience is registered only somatically. If we later see, hear or smell something reminiscent of the trauma, the somatic memory may be triggered. Still disconnected from the part of the brain that remembers the event as a narrative within a time and place, the trauma will feel as if it’s happening again now. This is PTSD. To protect us from the intolerable experience of being re-traumatised, dissociation may kick in whenever the body (linked to the right brain) senses potential triggers, creating huge disruption to living our lives.

Relational trauma

If we define trauma as an experience of terror and impotence in the face of annihilation – either physical or psychical - then many experiences could be called traumatic. The extent of so-called ‘relational’ or ‘developmental’ trauma, is described by one US expert as an ‘epidemic.’ This is childhood trauma such as sexual, physical or emotional abuse or neglect, and more broadly, growing up caregivers who can’t recognise or meet our needs when we are so young that the survival of our sense of self depends on it. Such caregivers may, to varying degrees, collapse, ignore or retaliate in the face of a child’s expression of need; they may be struggling in difficult circumstances, or their own experience of being parented may have deprived them of the capacity to understand, respond to or cope with their child.

Infants and very young children cannot regulate themselves emotionally or physiologically; they rely on their caregivers to do this for them until, through being regulated in relationship, they develop this capacity in themselves. The absence of regulation by those an infant depends on, exposes him/her to emotionally and physiologically intolerable states that can feel like psychic annihilation. To survive this trauma, dissociation kicks in, effectively disconnecting mind from body. Traumatic experience and self-states unmet by early caregivers (for example being helpless or distressed) are then dissociated from a conscious sense of ‘me’. Babies and toddlers don’t yet have the language to process or make sense of their experiences, contributing to this disconnection. The body knows and remembers the traumatic feeling states but there are no words to describe them.

At the root of trauma we often find an embodied state of shame. As babies and young children, we can’t yet distinguish between an environment that fails to support us in being ourselves, and whom we are. We experience ourselves, rather than the environment on which we depend, as wrong. We are likely, then, to feel, believe and behave as if we are worthless and the outside world is unsafe or hostile.

Dissociation as an adaptive mechanism may enable survival through traumatic relational interactions that objectify, violate, shame, or psychically annihilate. But from being a means of escape, it can become a prison. The mechanism will likely continue to kick in whenever a relational interaction seems reminiscent of the original trauma. As far as the body and unconscious (or right brain) are concerned, it’s not safe, even if consciously we may now live in a different time, place and relationship.

Some may re-experience dissociation whenever triggered, finding themselves feeling utterly cut off from the world around them and from their own body, for hours, days or even weeks. For others, unprocessed, dissociated, parts of the self, may drive behaviours or patterns of relating. These may be unconscious attempts to avoid, heal, or re-enact the original trauma in the hope of a different outcome. It's not uncommon for clients to present in therapy with a problematic and incomprehensible behaviour they describe as 'not me' (or perhaps something they can’t tolerate in others). ‘Not me’ can describe perfectly, the part of them that has been dissociated. The helpless, objectified child, for example, may embody any of a multitude of behaviours such as angry outbursts, bingeing, sexual promiscuity, or impulsive behaviour. Our relationships with our selves - including our bodies, what we do to them and what we put into them – reflect our early relationships – whether nurturing and responsive, or neglectful, painful or abusive.

It may feel threatening to become aware of such wounded parts of ourselves, to consciously come to know and eventually come to terms with them. This is where therapy and the therapeutic relationship can help.

Therapy, relational trauma and dissociation

The relationship with the therapist offers a space both for familiar relational dynamics to emerge and be explored, and for new relational experiences to be created. It offers both regulation and potential reminders of traumatic dysregulation. Aspects of the therapeutic relationship may trigger dissociation and therapists are trained to pick up on underlying dissociated experience, which can show up quite subtly, for example the client (and the therapist too) might abruptly change the subject, go blank, feel unable to be present, lose connection to what they are saying or to parts of their body, experience visual disturbance, unexplained bodily sensations, or get sleepy. These states and their triggers can be explored, increasing awareness of them at an embodied level, processing emotion and finding words and meaning.

Getting in touch with the traumatic experience underlying dissociative states is a possibility. This can be distressing however there are ways to minimise the risk of re-traumatisation. For example, developing a strong therapeutic relationship in which you can work collaboratively and carefully, getting to know the edge of what’s tolerable, and working with your therapist to develop inner resources you can draw on. Your so-called 'window of tolerance' can be gradually widened, so that what was once intolerable and dissociated becomes conscious, survivable and increasingly manageable.

As trauma and dissociation occur on a spectrum, their imprint may range from perhaps limiting us in some areas, to leaving us in a state of constant fear and disrupting our lives, to creating a fragmented rather than continuous sense of self. For some clients it may be appropriate to pursue a recognised, specialised therapeutic approach to trauma, such as EMDR. There are many different paths to healing.

The more our self-states are accessible, the more fully and freely we can experience life. We may still feel the pull of familiar triggers, but can respond through mindful awareness and choice rather than unconscious action.